Fluorescent handpiece

ABSTRACT

A handpiece can treat biological tissue using electromagnetic radiation, which can be substantially fluorescent light. The handpiece includes a source of electromagnetic radiation and a nonlinear waveguide. The nonlinear waveguide is adjacent the source, receives electromagnetic radiation from the source, and delivers the electromagnetic radiation to the biological tissue. The handpiece also includes a system for circulating a fluorescent substance through the nonlinear waveguide. The fluorescent substance is capable of modulating at least one property of the electromagnetic radiation.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.12/014,989, filed Jan. 16, 2008, now U.S. Pat. No. 7,955,367, which isexpressly incorporated by reference in its entirety.

BACKGROUND OF THE INVENTION

1. Field of the Invention

The invention relates generally to apparatuses and methods for treatingbiological tissue using electromagnetic radiation. In particular, theinvention relates to a fluorescent handpiece for treating biologicaltissue.

2. Description of the Related Art

Certain treatments for cosmetic and dermatologic conditions include theuse of non-coherent fluorescent light or intense pulsed light. Forexample, devices can include a fluorescent substance or dye fortransforming a first predetermined wavelength band of light to a secondpredetermined pulsed wavelength band of light, a first light source forproducing light including said first predetermined wavelength band, anda waveguide for directing said second predetermined pulsed wavelengthband to a predetermined location. Unfortunately, the efficacy of the dyecan suffer from quenching, bleaching, and other chemical reactions.Also, because the fluorescent substance or dye is heated duringoperation, and because heating can limit the useful lifetime of the dye,such devices can address the heating of the fluorescent substance ordye. For example, the dye can be circulated through a separate baseunit, to mitigate quenching, bleaching, and other chemical reactions, orto cool the dye in an attempt to extend its useful lifetime. However,the volume of circulating dye can be large and the system required tostore, pump, and circulate the dye can be large. Due to the volume ofdye and the size of the system, these components are generally in a baseunit separate from the treatment handpiece.

SUMMARY OF THE INVENTION

The invention, in various embodiments, relates to apparatuses andmethods for treating biological tissue using electromagnetic radiation.The biological tissue can be human skin, which can exhibit at least oneof superficial vascular lesion, port wine stain, telangiectasia, smallvessel diameter lesion, arterial lesion, capillary lesion, venouslesion, pigmented lesions, tattoos and other dermatological indicationssuch as acne, psoriasis, vitiligo, and the like. The invention can alsobe used to treat wrinkles, for skin rejuvenation, for hair removal, andfor hair regrowth. Apparatuses can include fluorescent handpieces thatinclude a source of electromagnetic radiation, a nonlinear waveguide,and a system for circulating a fluorescent substance through thenonlinear waveguide. Advantages of the invention can include anapparatus that can be smaller, less expensive, easier to handle, easierto store, more efficient, and more robust than prior art sources ofelectromagnetic radiation. Other advantages of the invention can includeextending the usable lifetime of the fluorescent substance by at leastone of mitigating quenching of the fluorescent substance, mitigatingbleaching of the fluorescent substance, mitigating heating of thefluorescent substance, and mitigating chemical reaction of thefluorescent substance.

In one aspect, the invention features a handpiece for treatingbiological tissue. The handpiece includes a source of electromagneticradiation, a nonlinear waveguide and a system for circulating afluorescent substance through the nonlinear waveguide. The nonlinearwaveguide is adjacent the source, receives electromagnetic radiationfrom the source, and delivers modulated electromagnetic radiation to thebiological tissue. The fluorescent substance is capable of modulating atleast one property of the electromagnetic radiation.

In another aspect, the invention features an apparatus for treatingbiological tissue. The apparatus includes a base unit, an energy sourceassociated with the base unit, and an umbilicus. The umbilicus has afirst end associated with the base unit and a conduit for transmittingenergy from the energy source to a second end of the umbilicus. Theapparatus also includes a handpiece associated with the second end ofthe umbilicus. The handpiece includes a source of electromagneticradiation, a nonlinear waveguide, and a system for circulating afluorescent substance through the nonlinear waveguide. The source isadapted for receiving energy from the energy source through the conduit.The nonlinear waveguide is adjacent the source, receives electromagneticradiation from the source, and delivers modulated electromagneticradiation to the biological tissue. The fluorescent substance is capableof modulating at least one property of the electromagnetic radiation.

In still another aspect, the invention features a method of treatingbiological tissue. The method includes (i) providing electromagneticradiation to a nonlinear waveguide associated with a handpiece; (ii)circulating a fluorescent substance through the nonlinear waveguide tomodulate at least one property of the electromagnetic radiation; and(iii) delivering the modulated electromagnetic radiation to treat thebiological tissue.

In other examples, any of the aspects above, or any apparatus or methoddescribed herein, can include one or more of the following features.

In various embodiments, the source can be selected from the groupconsisting of a flash lamp, a xenon flashlamp, a krypton flash lamp, axenon-krypton flash lamp, an arc lamp, a diode, and an incoherent lightsource. In one embodiment, the handpiece includes a coating associatedwith the nonlinear waveguide for enhancing emission of theelectromagnetic radiation.

In some embodiments, the handpiece includes a pump within the system forcirculating the fluorescent substance through the nonlinear waveguide.In one embodiment, the handpiece includes a system for cooling thefluorescent substance. The handpiece can include a port adjacent thesystem, the port in fluid communication with the system and adapted forreceiving the fluorescent substance. The handpiece can include a portthat is adapted for receiving the fluorescent substance from a reservoircartridge, the reservoir cartridge detachably connectable with the port.

In certain embodiment, the handpiece includes a reflector adjacent aproximal end of the nonlinear waveguide, the reflector for reflectinglight to a distal end of the nonlinear waveguide for delivery to thebiological tissue. In one embodiment, the modulated electromagneticradiation delivered to the biological tissue is substantiallyfluorescent light. The system can extend the usable lifetime of thefluorescent substance by at least one of mitigating quenching of thefluorescent substance, mitigating bleaching of the fluorescentsubstance, mitigating heating of the fluorescent substance, andmitigating chemical reaction of the fluorescent substance.

In various embodiments, the handpiece includes a connector adjacent afirst portion of the handpiece, for connecting the handpiece to anumbilicus and for receiving energy from a conduit in the umbilicus, theenergy for driving the source of electromagnetic radiation. In oneembodiment, the connector is adapted to receive a fluorescent substancefrom the umbilicus and is in fluid communication with the system forcirculating the fluorescent substance through the nonlinear waveguide.

In some embodiments, the electromagnetic radiation delivered to thebiological tissue can be characterized by a pulse width between about0.5 ms and about 100 s. In one embodiment, the electromagnetic radiationdelivered to the biological tissue is absorbed preferentially byhemoglobin in blood over adjacent skin tissue. A spectrum characterizingthe electromagnetic radiation delivered to the biological tissue canmatched to an absorption spectrum of at least one of whole blood,hemoglobin, reduced hemoglobin, and oxidized hemoglobin. Theelectromagnetic radiation delivered to the biological tissue can becharacterized by a spot size of about 2 mm or greater.

In certain embodiments, modulating at least one property of theelectromagnetic radiation can include varying at least one of awavelength, fluence, pulse or pulse train width (e.g., duration), andpulse or pulse train shape associated with the electromagneticradiation. In one embodiment, the electromagnetic radiation delivered tothe biological tissue is characterized by an energy density betweenabout 0.1 J/cm2 and about 500 J/cm2.

In various embodiments, the handpiece includes a skin contacting portionadjacent the waveguide for contacting the biological tissue anddelivering the electromagnetic radiation to the biological tissue. Inone embodiment, the handpiece includes a controller for tuning a pulsewidth characterizing the electromagnetic radiation delivered to thebiological tissue.

In some embodiments, the apparatus includes a port associated with thehandpiece and a cartridge containing the fluorescent substancedetachably connectable to the port, the cartridge providing thefluorescent substance to the system. In one embodiment, the apparatusincludes a reservoir for the fluorescent substance, the reservoirassociated with the base unit and in fluid communication with thesystem, through the umbilicus, for providing the fluorescent substanceto the system. The handpiece can be detachable from the umbilicus. Thebase unit can be detachable from the umbilicus.

In certain embodiments, the method includes treating skin having atleast one of a superficial vascular lesion, port wine stain,telangiectasia, small vessel diameter lesion, arterial lesion, capillarylesion, venous lesion, pigmented lesion, tattoo, acne, psoriasis, andvitiligo. In one embodiment, the method includes delivering theelectromagnetic radiation to the biological tissue in a train of pulsesto gradually heat a region of the biological tissue to be treated. Inanother embodiment, the method includes delivering the electromagneticradiation to the biological tissue in a train of pulses to first heat aregion of the biological tissue to be treated to a predeterminedtemperature and second to maintain the region of the biological tissueto be treated at about the predetermined temperature. Modulating atleast one property of the electromagnetic radiation can include varyingat least one of a wavelength, fluence, pulse or pulse train width, andpulse or pulse train shape associated with the electromagneticradiation.

Other aspects and advantages of the invention will become apparent fromthe following drawings and description, all of which illustrateprinciples of the invention, by way of example only.

BRIEF DESCRIPTION OF THE DRAWINGS

The advantages of the invention described above, together with furtheradvantages, may be better understood by referring to the followingdescription taken in conjunction with the accompanying drawings. Thedrawings are not necessarily to scale, emphasis instead generally beingplaced upon illustrating the principles of the invention.

FIG. 1 illustrates various aspects of a fluorescent handpiece.

FIG. 2 illustrates an exemplary arrangement of some aspects of afluorescent handpiece.

FIG. 3 illustrates another view of certain aspects of a fluorescenthandpiece.

FIG. 4 illustrates an embodiment of an apparatus for treating biologicaltissue.

FIG. 5 illustrates a method for treating biological tissue using afluorescent handpiece.

FIGS. 6A-D illustrate the exemplary embodiments of FIGS. 1-4, in 3Drenderings produced by CADD-type software.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

FIG. 1 illustrates various aspects of a fluorescent handpiece 100 fortreating biological tissue using electromagnetic radiation. Thehandpiece 100 includes a source 105 of electromagnetic radiation and anonlinear waveguide 110 adjacent the source 105. The source 105 caninclude a cover 120 and can have a gas in its interior 125. The source105 can have positive 150 and negative 155 terminals, for establishing acircuit to deliver energy to drive the source 105. The waveguide 110 caninclude a pipe 130 and a passage 135 for a fluorescent substance. Thehandpiece 100 can include a system 115 for circulating a fluorescentsubstance through the waveguide 110. The handpiece 100 can also includea conduit 165 that establishes fluid communication between the waveguide110, the system 115, and a reservoir 160. Further, the handpiece 100 caninclude a skin contacting portion 140 adjacent the waveguide 110 and areflector 170 adjacent a proximal end of the waveguide 110. Furthermore,the handpiece 100 can include cooling system 145 in thermalcommunication with at least one of the source 105, the waveguide 110,and the system 115. In the illustrated embodiment, the cooling system145 includes an intake 175 and an exhaust 180, for receiving andremoving coolant.

In various embodiments, the source 105 can be a flash lamp, a xenonflashlamp, a krypton flash lamp, a xenon-krypton flash lamp, an arclamp, a diode, and an incoherent light source. The handpiece 100, invarious embodiments, can include one, two, three, or more sources. Thewaveguide 110 receives electromagnetic radiation from the source 105 anddelivers electromagnetic radiation to the biological tissue (not shown).The waveguide 110 can include a glass, plastic, borosilicate, silicate,sapphire, poly methyl methacrylate (PMMA), or any other suitabletransparent material. The waveguide 110 can include a coating forenhancing emission of the electromagnetic radiation. For example, thecoating can be at least one of a metal, silica, silica-titania, titania,and organic material. In one embodiment, the waveguide 110 is a singletube waveguide adapted for containing a fluorescent substance. In otherembodiments, a waveguide can be a co-axial waveguide adapted forseparately containing two or more fluorescent substances.

The waveguide 110 can be adapted to deliver electromagnetic radiationdirectly to the biological tissue, or can be adapted to deliverelectromagnetic radiation to the biological tissue through a skincontacting portion 140 adjacent the waveguide 110. The skin contactingportion 140 can include a glass, silica, sapphire, or plastic. Theelectromagnetic radiation delivered to the biological tissue can besubstantially fluorescent light. In various embodiments, the handpiece100 includes a reflector 170 adjacent a proximal end of the waveguide110. The reflector 170 is adapted for reflecting light to a distal endof the nonlinear waveguide for delivery to the biological tissue. In oneembodiment, the reflector 170 is a minor. In another embodiment, thereflector 170 is a white (e.g., does not substantially absorbelectromagnetic radiation) surface. The reflector 170 can wrap aroundthe waveguide 110 and/or the source 105, to increase the amount ofelectromagnetic radiation delivered to the waveguide 110. The reflector170 can be an ellipsis or other geometrical shape selected to focusand/or deliver electromagnetic radiation from the source 105 to thewaveguide 110.

FIG. 2 illustrates an exemplary arrangement of various aspects of afluorescent handpiece. In various embodiments, the waveguide 110 isseparated by a distance d1 from the source 105, which can mitigateheating of the waveguide 110 and the fluorescent substance by the source105 by mitigating the thermal communication between the source 105 andthe waveguide 110. The separation distance d1 can also mitigate heatingby facilitating a coolant, or other cooling element, to be disposedbetween the source 105 and the waveguide 110. In one embodiment,distance d1 can be about 10 mm. In various embodiments, the waveguide110 has a length l1, which can be greater than or equal to the length l2of the source 105 (e.g., arc length, excluding the dimension of theelectrodes), which can facilitate transmission of electromagneticradiation to substantially the entire length of the waveguide 110 and/ormaximize the use of the fluorescent substance. In one embodiment, lengthl1 can be about 1 mm shorter than the length l2 (e.g., 0.5 mm shorter ateach end). In various embodiments, the waveguide 110 is separated by adistance d2 from the skin contacting portion 140. In one embodiment, thedistance d2 is about 0.5 mm. In various embodiments, the waveguide 110has a diagonal length l3 that is less than a corresponding diagonallength l4 of the skin contacting portion 140. In one embodiment, lengthl4 is about two times distance d2 longer than length l3 (e.g.,l4≈2d2+13), to direct the cone electromagnetic radiation emitted fromwaveguide 110 to the skin. However, the lengths 14 and 13 are notlimited to this relationship and can be substantially the same, greater,or lesser.

In another embodiment, the waveguide 110 and the skin contacting portion140 are substantially in contact. In one embodiment, the waveguide 110and the reflector 170 are not in direct contact or are otherwiseseparated (e.g., intervened by a gas, liquid, or solid). This separationcan facilitate cooling of the waveguide 110, for example, by increasingthermal communication between the waveguide 110 and a coolant or othercooling element. This spatial separation can also be designed tooptimize the reflection of electromagnetic radiation from a proximal endof the waveguide 110, to the reflector 170, and back into the waveguide110. In another embodiment, the waveguide 110 and the reflector 170 aresubstantially in contact. The relative positions, sizes, and/or opticalproperties (e.g., convexity/concavity) of the waveguide 110 and thereflector 170 can be designed to maximize the amount of electromagneticradiation reflected back into the waveguide.

The fluorescent substance can be circulated by the system 115 throughthe waveguide 110, and is capable of modulating at least one property ofthe electromagnetic radiation. The system 115 can help extend the usablelifetime of the fluorescent substance by at least one of mitigatingquenching of the fluorescent substance, mitigating bleaching of thefluorescent substance, mitigating heating of the fluorescent substance,and mitigating chemical reaction of the fluorescent substance. In someembodiments, the system 115 can be adjacent a port, which is in fluidcommunication with the system and adapted for receiving the fluorescentsubstance from a reservoir 160. In one embodiment, the port is adaptedfor receiving the fluorescent substance from a cartridge that isdetachably connectable with the port. A cartridge can contain about 2deciliters, or more, or less, of the fluorescent substance. In otherexample, the port can be adapted for receiving the fluorescent substancefrom another source such as an umbilicus that can be attached to thehandpiece 100. A conduit 165 establishes a fluid communication betweenthe waveguide 110, the system 115, and the port.

The system 115 can include a pump for circulating the fluorescentsubstance. The pump can be any type of pump suitable for a fluorescentsubstance, including a bellows, centrifugal, diaphragm, drum, flexibleliner, flexible impeller, gear, peristaltic (e.g., tubing), piston,progressive cavity, rotary lobe, rotary vane, or syringe pump. In oneembodiment, the pump is a magnetically-coupled gear-type pump. Inanother embodiment, the pump is a solenoid operated pump. In variousembodiments, the pump can include a polytetrafluoroethylene (PTFE, forexample TEFLON®, a registered trademark of E. I. du Pont de Nemours andCompany) or a stainless steel material defining at least a portion of acirculation path of the fluorescent substance. PTFE, or a material withsimilar physical and chemical properties, can be used in the seals. Pumpmaterials can be selected that are essentially chemically inert, forexample, with respect to the fluorescent substance and the operatingenvironment.

FIG. 3 illustrates a cross sectional view 150 of a portion of thefluorescent handpiece of FIG. 1. The source 105 can include a cover 120and can have a gas in its interior 125. In one example, the gas isxenon. In general, the source 105 is selected to emit at least awavelength of light employed by the fluorescent substance. In oneembodiment, the passage 135 through the waveguide 110 has a diameter ofabout 2 mm. In one embodiment, the thickness of the pipe 130 wall can beabout 0.5 mm. In general, the passage 135 has a diameter is selected tocontain a sufficient volume of fluorescent substance, the thickness ofthe pipe 130 wall is selected based upon the material to providesufficient structural integrity, and the total diameter of the waveguide110 is chosen with regard to the desired spot size to be produced by thehandpiece 100.

In general, the fluorescent substance is capable of modulating (e.g.,transforming, converting, or varying) at least one property of theelectromagnetic radiation. For example, the fluorescent substance can bea dye selected to convert the electromagnetic radiation from at leastone first wavelength to at least one second wavelength. In someembodiment, more than one dye can be employed to utilize the light fromthe source 105. Accordingly, at least one dye can be selected dependingupon the desired treatment and/or desired emission wavelength. Becausethe emission wavelength can be controlled by selecting one or moreappropriate dyes, the fluorescent handpiece 100 does not require afilter to obtain the desired emission wavelength. However, in someembodiments, the fluorescent handpiece 100 can include a filter forcontrolling the wavelengths delivered to the biological tissue.

The absorbing and emitting wavelengths of the fluorescent substance canbe selected by the user or a technician. In one example, the fluorescentsubstance can change blue-green light to yellow light. For example, thefluorescent substance can be a liquid dye such as pyrromethene,preferably pyrromethene 580, for changing light emitted from the source105 to the desired wavelength. A suitable concentration can be aconcentration sufficient to achieve about 100% absorption ofelectromagnetic radiation. The liquid base can be, for example, analcohol or a mixture of alcohols, preferably methanol and/or ethanol. Invarious embodiments, the fluorescent substance can include4-dicyanomethylene-2-methyl-6-(p(dimethylamino)styryl)-4H-pyran (DCM),pyrromethene, fluorescein, coumarin, stilbene, umbelliferone, tetracene,malachite green, rhodamine, or rhodamine 6G. In various embodiments,adamantane can be added to a fluorescent substance to prolong its life.In some embodiments, cycloheptatriene and cyclooctatetraene can be addedto a fluorescent substance as triplet quencher, to increase outputpower. In certain embodiments, a fluorescent substance can include oneor more pyrromethenes. The reflection index for the liquid can differstrongly from the reflection index in the waveguide 110. One suitableflow rate for the liquid can be about 4 L/min. The passage 135 can bepart of the system 115.

In various embodiments, the cooling system 145 can be a system forcooling the fluorescent substance. In some embodiments, the system 115for circulating a fluorescent substance can function as, or include a,system for cooling the fluorescent substance. The cooling system 145 canalso be adapted to cool any of the components of the handpiece 100,and/or to cool the biological tissue. The cooling system 145 can be inthermal communication with at least one of the source 105, the waveguide110, the skin contacting portion 140, and the system 115. The coolingsystem 145 can employ a coolant such as a gas or liquid to cool at leastone of the source 105, the waveguide 110, the skin contacting portion140, and the system 115. In one embodiment, the cooling system 145employs water as a coolant. In one embodiment, the cooling system 145has an intake 175 and an exhaust 180, for receiving and removing coolantin the cooling system 145. In one embodiment, the cooling system 145includes a Peltier, or thermo-electric cooler. The cooling system 145can include a radiator.

U.S. Pat. No. 5,320,618, the disclosure of which is incorporated hereinby reference in its entirety, teaches various sources, waveguides,systems, systems for cooling, and other aspects that can be readilyadapted by one skilled in the art for use with the present invention.

In various embodiments, the electromagnetic radiation delivered to thebiological tissue is characterized by a pulse width between about 0.5 msand about 100 s. In some embodiments, a pulse width is between about 5ms and about 50 ms. In some embodiments, a pulse width is about 1, 2, 3,4, 5, 10, 15, or 20 s. The electromagnetic radiation delivered to thebiological tissue can be absorbed preferentially by a chromophore in theskin. For example, the chromophore can include at least one ofhemoglobin in blood, melanin, porphyrin, exogenous pigment, and water inthe skin. The chromophore can absorb the electromagnetic radiationpreferentially over adjacent skin tissue. The spectrum characterizingthe electromagnetic radiation delivered to the biological tissue can bematched to an absorption spectrum of at least one of whole blood,hemoglobin, reduced hemoglobin, and oxidized hemoglobin.

Electromagnetic radiation can also be delivered by scattering anddepth-determined deposition. For example, freckles of different shades(e.g., light, medium, and dark relative to surrounding skin) can betreated by different wavelengths of electromagnetic radiation (e.g.,about 480 nm for light, about 515 nm for medium, and about 535 nm fordark). A light freckle may not have enough pigment to absorb enoughelectromagnetic radiation to be effectively treated. By using a shorterwavelength, electromagnetic radiation can scatter more and penetrateless through the freckle, which can result in a longer path and moreabsorption within the freckle. In another example, a thicker, deeper(e.g. germal) blood vessel can be treated by a relatively longerwavelength, which can reach within the dermis, and a thinner, shallowerblood vessel can be treated by a relatively shorter wavelength. In oneembodiment, a thicker vessel can be treated by electromagnetic radiationof about 560 to 800 nm and a thinner vessel can be treated byelectromagnetic radiation of about 520 to 800 nm.

The electromagnetic radiation delivered to the biological tissue can becharacterized by a spot size between about 1 mm and about 20 mm. A spotsize can be up to about 1, 2, 3, 4, or 5 mm in diameter. In variousembodiments, the handpiece can produce a spot size of about 2 mm orgreater in diameter. In general, the optical diameter of the waveguideand the skin contacting portion are proportional to the diameter of thespot size when the skin contacting portion is in contact with the skin.

The electromagnetic radiation delivered to the biological tissue can becharacterized by an energy density between about 0.1 J/cm2 and about 500J/cm2. In various embodiments, the electromagnetic radiation deliveredto the biological tissue can be characterized by an energy densitybetween about 1 and about 100 60 J/cm2, about 2.5 J/cm2 and about 60J/cm2, or about 2.5 J/cm2 and about 12 J/cm2. In certain embodiments,the energy density can be about 1, 5, 10, 50, 100, 150, 200, 250, 300,350, 400, or 450 J/cm2. The handpiece can include means for tuning apulse width characterizing the electromagnetic radiation delivered tothe biological tissue.

FIG. 4 illustrates an embodiment of an apparatus 200 for treatingbiological tissue. The apparatus 200 includes a fluorescent handpiece100 that can include the features described in connection with FIG. 1.The apparatus 200 also includes a base unit 210 that can include atleast one of an energy 205 source, a coolant 225 source, and acontroller 250. The base unit 210 can be connected to the fluorescenthandpiece 100 by an umbilicus 215. The umbilicus 215 includes a first240 point of connection between the umbilicus 215 and the handpiece 100,and a second 245 point of connection between the umbilicus 215 and thebase unit 210. The umbilicus 215 can include a power 220 conduit fortransmitting energy from the energy 205 source to the source 105 ofelectromagnetic radiation via a circuit established through the positive150 and negative 155 terminals. The umbilicus 215 can also include acoolant 230 conduit that establishes coolant communication between thefluorescent handpiece 100 and the base unit 210.

In various embodiments the cooling system 145 can cool the fluorescentsubstance and/or other components of the handpiece 100. The coolingsystem 145 can be adapted for cooling biological tissue. The base unit210 can include a coolant 225 source that can deliver coolant to thecooling system 145 through a coolant 230 conduit. The coolant 230conduit travels through (or along or on the outside of) the umbilicus tothe cooling system 145 via a delivery or circulatory system establishedthrough the intake 175 and, if necessary, an exhaust 180. In someembodiments the coolant 230 conduit facilitates coolant flow only to(e.g., in the case of a gas that can be vented) or both to and from(e.g., in the case of fluid that can be circulated) the handpiece 100.In certain embodiments, the coolant 225 source includes means to controland/or circulate the coolant, and the coolant 230 conduit and coolingsystem 145 are simply channels. In one embodiment, the cooling system145 can control and/or circulate the coolant. In one embodiment, theapparatus 200 includes a radiator or heat exchanger in the handpiece 100or the base unit 210.

In some embodiments, the apparatus 200 includes a controller 250 forcontrolling at least one of the energy 205 source, the coolant 225source, the cooling system 145, and the source 105.

FIG. 4 illustrates a first 240 point of connection between the umbilicus215 and the handpiece 100, and a second 245 point of connection betweenthe umbilicus 215 and the base unit 210. In some embodiments, thesepoints of connection are essentially fixed at the time of manufacture orassembly and are not detachable without specialized tools. However, invarious embodiments, these points of connection are easily and quicklydetachable and reattachable without specialized tools. In someembodiments, the first 240 point of connection is detachable andreattachable such that a practitioner or technician can easily andquickly change handpieces in a clinical situation. For example, theapparatus can also include a first connector associated with the secondend of the umbilicus and a second connector associated with thehandpiece, the second connector detachably connectable to the firstconnector. In various embodiments, the handpiece includes a connectoradjacent a first portion of the handpiece, for connecting the handpieceto an umbilicus and for receiving energy from a conduit in theumbilicus, the energy for driving the source of electromagneticradiation. The connector can be adapted to receive a fluorescentsubstance from the umbilicus and is in fluid communication with thesystem for circulating the fluorescent substance through the nonlinearwaveguide. This has the advantage of allowing multiple handpieces to beused with a single base unit 210 and/or single umbilicus 215. Likewise,in some embodiments, the second 245 point of connection is detachableand reattachable such that the base unit is detachable from theumbilicus. U.S. patent application Ser. No. 11/800,663, the disclosureof which is incorporated herein by reference in its entirety, teachesvarious detachable handpieces and connectors that can be readily adaptedby one skilled in the art for use with the present invention.

FIG. 5 illustrates a method 400 for treating biological tissue using afluorescent handpiece. Step 405 includes providing electromagneticradiation to a nonlinear waveguide associated with a handpiece. Thehandpiece can include aspects described in connection with FIGS. 1-4.Step 410 includes circulating a fluorescent substance through thenonlinear waveguide to modulate at least one property of theelectromagnetic radiation. Modulating at least one property of theelectromagnetic radiation can include varying at least one of awavelength, fluence, pulse or pulse train width, and pulse or pulsetrain shape associated with the electromagnetic radiation. Step 415includes delivering the modulated electromagnetic radiation to treat thebiological tissue.

In some embodiments, the method 400 includes treating skin having atleast one of a superficial vascular lesion, port wine stain,telangiectasia, small vessel diameter lesion, arterial lesion, capillarylesion, venous lesion, pigmented lesion, tattoo, acne, psoriasis, andvitiligo. The method 400 can also include treatments for wrinkles, forskin rejuvenation, for hair removal, and for hair regrowth. In certainembodiments, the method 400 includes delivering the electromagneticradiation to the biological tissue in a train of pulses to graduallyheat a region of the biological tissue to be treated.

FIGS. 6A-D illustrate the exemplary embodiments of FIGS. 1-4, in 3Drenderings produced by CADD-type software. The reference numbers inFIGS. 6A-D correspond to the elements discussed in connection with FIGS.1-4.

While the invention has been particularly shown and described withreference to specific embodiments, it should be understood by thoseskilled in the art that various changes in form and detail may be madewithout departing from the spirit and scope of the invention as definedby the appended claims.

1. A method of treating biological tissue, comprising: providing afluorescing handpiece system adapted to treat biological tissue, saidfluorescing handpiece system comprising: a nonlinear waveguide, thenonlinear waveguide positioned to receive electromagnetic energy from anelectromagnetic energy source, the nonlinear waveguide comprising: firstand second ends, and a wall extending at least partially therebetween,the wall configured to transmit the electromagnetic radiationtherethrough; a passage extending along a direction between said firstand second ends; a fluorescent substance flowable within the passage,the fluorescent substance configured to absorb the electromagneticradiation and generate fluorescent light in response to theelectromagnetic radiation; and an input port and an output port in fluidcommunication with the passage; an optical output element near one ofthe first and second ends of the nonlinear waveguide; a fluid conduit influid communication with the input and output ports; and a fluidcirculation system in fluid communication with the first and second endsof the passage; circulating the fluorescent substance from the first endto the second end through the passage and from the second end back tothe first end through the fluid conduit with the fluid circulationsystem; transmitting electromagnetic radiation through the wall of thenonlinear waveguide to the fluorescent substance within the passage;guiding at least some of the fluorescent light emitted by thefluorescent substance in response to the electromagnetic radiationthrough the nonlinear waveguide towards the optical output element;directing the fluorescent light towards hair with the optical outputelement; and removing said hair with said directed fluorescent light. 2.The method of claim 1, further comprising delivering the fluorescentlight to the hair in a train of pulses to gradually heat a region to betreated.
 3. The method of claim 1, further comprising delivering thefluorescent light to the biological tissue in a train of pulses to firstheat a region to be treated to a predetermined temperature and second tomaintain the region to be treated at about the predeterminedtemperature.
 4. The method of claim 1, further comprising circulatingcooling fluid between the waveguide and the source of electromagneticradiation.
 5. A method of treating biological tissue, comprising:providing a fluorescing handpiece system adapted to treat biologicaltissue, said fluorescing handpiece system comprising: a nonlinearwaveguide, the nonlinear waveguide positioned to receive electromagneticenergy from an electromagnetic energy source, the nonlinear waveguidecomprising: first and second ends, and a wall extending at leastpartially therebetween, the wall configured to transmit theelectromagnetic radiation therethrough; a passage extending along adirection between said first and second ends; a fluorescent substanceflowable within the passage, the fluorescent substance configured toabsorb the electromagnetic radiation and generate fluorescent light inresponse to the electromagnetic radiation; and an input port and anoutput port in fluid communication with the passage; an optical outputelement near one of the first and second ends of the nonlinearwaveguide; a fluid conduit in fluid communication with the input andoutput ports; and a fluid circulation system in fluid communication withthe first and second ends of the passage; circulating the fluorescentsubstance from the first end to the second end through the passage andfrom the second end back to the first end through the fluid conduit withthe fluid circulation system; transmitting electromagnetic radiationthrough the wall of the nonlinear waveguide to the fluorescent substancewithin the passage; guiding at least some of the fluorescent lightemitted by the fluorescent substance in response to the electromagneticradiation through the nonlinear waveguide towards the optical outputelement; directing the fluorescent light towards a skin region with theoptical output element; and stimulating hair growth at said skin regionwith said directed fluorescent light.
 6. The method of claim 5, furthercomprising delivering the fluorescent light to the skin region in atrain of pulses to gradually heat the skin region.
 7. The method ofclaim 5, further comprising delivering the fluorescent light to the skinregion in a train of pulses to first heat a region to be treated to apredetermined temperature and second to maintain the region to betreated at about the predetermined temperature.
 8. The method of claim5, further comprising circulating cooling fluid between the waveguideand the source of electromagnetic radiation.
 9. A method of treatingbiological tissue, comprising: providing a fluorescing handpiece systemadapted to treat biological tissue, said fluorescing handpiece systemcomprising: a nonlinear waveguide, the nonlinear waveguide positioned toreceive electromagnetic energy from an electromagnetic energy source,the nonlinear waveguide comprising: first and second ends, and a wallextending at least partially therebetween, the wall configured totransmit the electromagnetic radiation therethrough; a passage extendingalong a direction between said first and second ends; a fluorescentsubstance flowable within the passage, the fluorescent substanceconfigured to absorb the electromagnetic radiation and generatefluorescent light in response to the electromagnetic radiation; and aninput port and an output port in fluid communication with the passage;an optical output element near one of the first and second ends of thenonlinear waveguide; a fluid conduit in fluid communication with theinput and output ports; and a fluid circulation system in fluidcommunication with the first and second ends of the passage; circulatingthe fluorescent substance from the first end to the second end throughthe passage and from the second end back to the first end through thefluid conduit with the fluid circulation system; transmittingelectromagnetic radiation through the wall of the nonlinear waveguide tothe fluorescent substance within the passage; guiding at least some ofthe fluorescent light emitted by the fluorescent substance in responseto the electromagnetic radiation through the nonlinear waveguide towardsthe optical output element; directing the fluorescent light towards askin region with the optical output element; and providing skinrejuvenation with said directed fluorescent light.
 10. The method ofclaim 9, further comprising delivering the fluorescent light to the skinregion in a train of pulses to gradually heat the skin region.
 11. Themethod of claim 9, further comprising delivering the fluorescent lightto the skin region in a train of pulses to first heat a region to betreated to a predetermined temperature and second to maintain the regionto be treated at about the predetermined temperature.
 12. The method ofclaim 9, further comprising circulating cooling fluid between thewaveguide and the source of electromagnetic radiation.